Do Lesbian Patients Need Lesbian Therapists? A Professional Weighs In.

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We sat down with therapist and former women’s studies professor Nanette Shaw, PhD, to discuss the benefits lesbian patients can glean from seeing therapists who share their sexual identity.

“Do I need a queer therapist?”

It’s one of the first questions that many LGBTQ individuals ask themselves during the search for a mental healthcare professional. And while the answer undoubtedly varies from person to person, it is in many cases a resounding “yes.”

We caught up with Dr. Nanette Shaw to discuss the tangible benefits that lesbian patients can reap when they work with a therapist or mental healthcare provider who shares their sexual orientation.

1. A Lesbian Identity Does Not Mean Lesbian-Focused Therapy

Just because a lesbian patient is interested in therapy does not mean that the only thing up for discussion is the patient’s sexual orientation. Thanks to their own lived experiences, lesbian providers working with lesbian patients understand this, and are able to look at the patient holistically. They deal with the presenting problem, whatever that might be.

“I never assume that my lesbian patients are in therapy because of their sexuality,” says Dr. Shaw. “Some of them are, but many of them aren’t, and it’s important to see what the issues at hand truly are.”

Dr. Shaw notes that many therapists will assume LGBTQ patients are in therapy because of trauma related to their sexuality or gender identity. This assumption can make patients feel pigeonholed, and therefore uncomfortable about sharing experiences or even redirecting the conversation to another area of their life. “As a lesbian myself, I’m not about to draw these conclusions” says Dr. Shaw. When a patient and provider share a sexual orientation, their provider will likely have a better understanding of the extent to which a patient wants or needs to discuss their sexuality.

2. Sexual Experiences Can Be Better Understood By a Lesbian Therapist

Dr. Shaw also finds that patients can more easily discuss fantasies when they know that their sexual desire will not be misunderstood, or perhaps worse, made an object of voyeuristic interest by a non-lesbian provider.

“A lesbian patient might not feel comfortable discussing intimate details or sexual fantasies with a straight therapist,” believes Dr. Shaw. “A straight therapist might simply have a heterosexual frame of reference about what sex and relationships, and even families should look like — whereas with a lesbian patient, we share a common language, and as Claude Levi-Strauss says ‘language is culture.’”

Dr. Shaw continues by pointing out that transference — especially erotic transference, a phenomenon characterized by the unconscious redirection of feelings from one person to another — can be easier to navigate for lesbian patients who are working with lesbian therapists. In therapy, transference often manifests when a patient redirects certain feelings about someone in their life (a parent, a friend, a partner, etc.) toward their therapist.

“Many patients experience transference during therapy,” maintains Dr. Shaw, “and having a therapist who is also lesbian can make dealing with that significantly smoother, while still unpacking a lot of material.”

Dr Shaw believes that when transference takes place, it’s less bewildering for patients whose therapists share this essential aspect of their identity — they don’t have to go down the rabbit hole of what it might mean about their sexuality and can accept that it’s a natural, common occurrence.

3. A Shared Understanding of Lesbian Experiences

“There’s an understanding of shared experiences between lesbians,” says Dr Shaw, “and a knowledge of the cultural and psychological history of queerness that I have found to be very valuable — especially to young lesbians.”

Although there is, of course, no single lesbian “experience,” there are perspectives and experiences that many lesbians share — be it an active rejection of patriarchal society, the formation of a tight-knit female social circle, or simply a knowledge of what’s it like to endure microaggressions and stereotypes on a daily basis.

Having a therapist who understands and shares these experiences can help facilitate a meaningful, deeper therapist-patient relationship, and save the patient from having to educate a non-lesbian provider about the nuances of same-sex relationships, or even a marginalized life.

“There’s a lot of explaining with a straight, cisgendered therapist,” says Dr. Shaw, “even with a gay or lesbian-affirming straight therapist. You don’t know what subtle judgements they might be making, or what biases they might have. Oftentimes, patients want to bypass that.”

How To Find A Therapist Who Shares Your Identity

“Lesbianism is a different way of life, and lesbian therapists understand that,” says Shaw. “It’s a self-concept, rather than just a sexual identity.”

Finding the right therapist can be challenging for anyone, but for lesbian patients looking for a lesbian therapist, the search can take even longer. At Lighthouse, our goal is to make it easy for patients to find an affirming, knowledgeable provider with credentials and experience that empower them to better serve the LGBTQ community.